Permanent resident

Research output: Contribution to journalArticle

Abstract

The training of physicians in the past century was based primarily on responsibility and the chain-ofcommand. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

Original languageEnglish (US)
Article number31160
JournalMedical Education Online
Volume21
Issue number1
DOIs
StatePublished - Jan 1 2016

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physician
resident
responsibility
health care delivery system
day care
teacher
Federal Government
medical student
revenue
medicine
staff
experience
Group
student

Keywords

  • Attending physician responsibilities
  • Medical education
  • Student and resident training

ASJC Scopus subject areas

  • Education

Cite this

Permanent resident. / Fisher, John F.

In: Medical Education Online, Vol. 21, No. 1, 31160, 01.01.2016.

Research output: Contribution to journalArticle

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